Katschinski B (1993). Smoking and ovulation inhibitor in inflammatory bowel diseases. Medizinische Klinik (Munich, Germany : 1983), 88 Suppl 1, 5-8.
Katschinski B. Smoking and ovulation inhibitor in inflammatory bowel diseases. Med Klin (Munich). 1993;88 Suppl 1:5-8.
Katschinski B. "Smoking and ovulation inhibitor in inflammatory bowel diseases." Medizinische Klinik (Munich, Germany : 1983), vol. 88 Suppl 1, 1993, pp. 5-8.
For EndNote, Zotero or Mendeley:
License
No open license is recorded for this paper. Reuse terms are set by the publisher.
Abstract
In a case-control study the effects of smoking and the use of oral contraceptives were examined in 83 patients with Crohn's disease and 37 patients with ulcerative colitis in comparison with members of the general population who served as controls. After controlling for oral contraceptives, smokers were found to have a significantly elevated relative risk of contracting Crohn's disease of 3.0 (1.3 to 6.8). Patients on oral contraceptives for more than three years had an elevated risk for Crohn's disease of 4.3 (1.3 to 14.4); this elevated risk was, however, found only in the non-smoking group. In the case of ulcerative colitis, the relative risk in smokers was significantly lower (0.21 [0.04 to 0.91]) than in non-smokers. The use of oral contraceptives does not represent a risk factor for ulcerative colitis. While smoking has been established as a risk factor in the development of inflammatory bowel disease, the role of oral contraceptives in the aetiology of this condition remains unclear.
Vessey M et al., 1986·Br Med J (Clin Res Ed)·Free full text on PubMed Central
Since the start in 1968 of the Oxford Family Planning Association contraceptive study 31 women have developed ulcerative colitis and 18 have developed Crohn's disease, giving incidences of 0.15 and 0.09/1000 woman years respectively. The incidence of ulcerative colitis in women who were non-smokers on entry to the study was 0.17/1000 woman years and the incidence in smokers was 0.11/1000 woman years. The findings for Crohn's disease were entirely different, the corresponding incidences being 0.05 and 0.17/1000 woman years respectively. Both ulcerative colitis and Crohn's disease were more common among women currently using oral contraceptives than among those not doing so. Incidences per 1000 woman years for ulcerative colitis were 0.26 in users and 0.11 in non-users; for Crohn's disease the incidences were 0.13 and 0.07 respectively. Though the association between the use of oral contraceptives and chronic inflammatory bowel disease cannot be regarded as established, the effects of smoking have been shown consistently in many studies. This observation provides an important clue to the aetiology of chronic inflammatory bowel disease.
We used rosters of the Crohn's and Colitis Foundation of America to identify potential cases and peer-nominated controls to explore the reported association between oral contraceptives and inflammatory bowel disease. Overall, women who used oral contraceptives were at increased risk of developing Crohn's disease (odds ratio = 1.49, 95% confidence interval (CI) = 0.99-2.26). The findings persisted after adjustment for age at symptom onset, decade of onset, education, marital status, and location of disease. There was an interaction with cigarette smoking; the risk associated with oral contraceptives was elevated in current smokers (odds ratio = 2.64, 95% CI = 1.22-5.75), but not in former smokers or never-smokers. The risk was not elevated for ulcerative colitis (odds ratio = 1.10, 95% CI = 0.65-1.85).
Gut and Inflammatory Bowel Disease · Inflammatory Bowel Disease
Khalili H et al., 2012·Gut·Free full text on PubMed Central
Oral contraceptive use has been associated with risk of Crohn's disease (CD) and ulcerative colitis (UC). To determine whether this association is confounded or modified by other important lifestyle and reproductive factors.
A prospective cohort study was carried out of 117,375 US women enrolled since 1976 in the Nurses Health Study I (NHS I) and 115,077 women enrolled since 1989 in the Nurses' Health Study II (NHS II) with no prior history of UC or CD. These women had provided information every 2 years, on age at menarche, oral contraceptive use, parity, menopause status and other risk factors. Diagnoses of CD and UC were confirmed by review of medical records. Cox proportional hazards models were used to calculate HRs and 95% CIs. Among 232,452 women with over 5,030,196 person-years of follow-up, 315 cases of CD and 392 cases of UC were recorded through 2007 in NHS II and 2008 in NHS I. Compared with never users of oral contraceptives, the multivariate-adjusted HRs for CD were 2.82 (95% CI 1.65 to 4.82) among current users and 1.39 (95% CI 1.05 to 1.85) among past users. The association between oral contraceptives and UC differed according to smoking history (pheterogeneity=0.04). Age at menarche, age at first birth and parity were not associated with risk of UC or CD. In two large prospective cohorts of US women, oral contraceptive use was associated with risk of CD. The association between oral contraceptive use and UC was limited to women with a history of smoking.
Data from the Royal College of General Practitioners Oral Contraception Study have been examined to determine whether oral contraceptive use was associated with the development of Crohn's disease or ulcerative colitis. Over a 17 year period Crohn's disease developed in 42 women and ulcerative colitis in 78. The incidence of both diseases was greater in oral contraceptive users compared to non-users with the rate ratio for Crohn's disease being 1.7 (95% confidence limits, 0.88, 3.2) and for ulcerative colitis being 1.3 (95% confidence limits 0.82, 2.0). For both diseases incidence was unrelated to parity or social class, but women smoking at recruitment had a greater incidence of Crohn's disease (rate ratio 1.8, 95% confidence limits 0.93, 3.3) and a reduced incidence of ulcerative colitis (rate ratio 0.68, 95% confidence limits 0.41, 1.1). Although these results are based on small numbers and could be chance findings, they are consistent with other studies showing associations between oral contraceptive use, smoking and the development of Crohn's disease and ulcerative colitis.
Lifestyle and Environment › Substances › Tobacco and Nicotine · Autoimmune and Inflammatory Disease › Gut and Inflammatory Bowel Disease › Inflammatory Bowel Disease
PMID 8464399 8464399 Katschinski et al. 1993, Katschinski 1993
Cite this article
Katschinski B (1993). Smoking and ovulation inhibitor in inflammatory bowel diseases. Medizinische Klinik (Munich, Germany : 1983), 88 Suppl 1, 5-8.
Katschinski B. Smoking and ovulation inhibitor in inflammatory bowel diseases. Med Klin (Munich). 1993;88 Suppl 1:5-8.
Katschinski B. "Smoking and ovulation inhibitor in inflammatory bowel diseases." Medizinische Klinik (Munich, Germany : 1983), vol. 88 Suppl 1, 1993, pp. 5-8.